Patient Age a Key Factor In the Decision to Get a Joint Replacement
Age always plays a huge part in the decision of whether to go through with a joint replacement or to wait several more years in an attempt to limit the risk of needing a revision. A study published in 2017 examined the correlation between patient age at the time of their joint replacement procedure and the percentage of revision surgeries performed at various age intervals for both male and female patients. Their findings were pretty startling.
The study identified around 63,000 total hip replacement patients and just over 54,000 total knee replacement patients between the years of 1991 and 2011. They followed up with these patients for up to 20 years. The age of these patients ranged from 50 years old to 85 years and older. For the most part, the implant survival rate was pretty high across both joint replacement groups. For hip replacement patients, the implant survival at the 10-year mark was 95.6% and 85% at 20 years. For knee replacement patients, the implant survival at the 10-year mark was 96.1% and 89.7% at 20 years. For patients who received their joint replacement at the age of 70 years or older, the risk of revision was only about 5%. Where their research gets interesting is when examining male patients in their early 50’s who marked a risk of revision of up to 35%. Female patients generally had consistently lower risk of revision rates at all age groups examined. The peak incidence of revision surgery occurred within 5 years of the initial procedure for all age groups.
What this data implies is that by getting a hip or knee replacement at younger ages leads to a much higher risk of needing a revision during the 20 year follow up time period, with most of those revisions coming within just 5 years. This can certainly sound disconcerting to many patients in that 50-70 year old age group. However, there are a couple of things we would like to point out with this study.
One, is that the surgical technique is never mentioned, therefore, leading us to assume that most, if not all, of these patients received their joint replacements following the traditional, mechanical alignment guide. If you’ve read some of our other posts, you’ve heard us talk about the downsides of this surgical technique, compared to more modern, advanced approaches to total joint replacement surgery.
The second aspect to this is that the reason for revision is never explored, meaning we don’t know what percentage of the patients needed revision surgery due to infection, dislocation, or other possible factors.
This is where more advanced methods for total joint replacement are critical to the success of implantation in younger patient populations. We know that CT based total joint replacement templating leads to more accurate implant sizing and positioning. If you would like to read more about CT based surgical planning, check out this post or this post. In order to truly recreate a patient’s natural, anatomical alignment you need more visual data than what standard x-rays can provide. You also need to treat each individual joint differently to achieve the best outcome. Getting the most accurate joint replacement possible is immensely important for limiting possible complications and post-operative dissatisfaction.
Kinomatic is taking personalized joint replacement procedures even further by adding virtual reality into the equation. No one of any age should feel forced to endure moderate or severe joint pain simply because they have been told they’re too young for a joint replacement.
To read the entire study referenced in this post, click here.
Bayliss LE, Culliford D, Monk AP, Glyn-Jones S, Prieto-Alhambra D, Judge A, Cooper C, Carr AJ, Arden NK, Beard DJ, Price AJ. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet. 2017 Apr 8;389(10077):1424-1430. doi: 10.1016/S0140-6736(17)30059-4. Epub 2017 Feb 14. Erratum in: Lancet. 2017 Apr 8;389(10077):1398. PMID: 28209371; PMCID: PMC5522532.